India Encephalitis 2018; 702 fatalities

[Ronan Kelly]

AES Death: WYD: Kavitha 25/F DOD 15.11.18,Porunnanoor
http://dhs.kerala.gov.in/pdf2018/drcd_15112018.pdf

Kerala has now reported 32 total cases of AES with 17 deaths. 5 cases, 2 fatal have tested positive for JE. 19 cases of Nipah with 18 fatalities (17 conf, 1 susp) have been reported this year.

[Ronan Kelly]

http://nvbdcp.gov.in/WriteReadData/l...1542173591.pdf

Comment: I remain skeptical of the numbers coming out of Uttar Pradesh. Up to June 29th 112 fatalities from 1,171 cases (9.6%) were reported. Since then 11 fatalities from 1,517 cases (0.73%). Media reports put the total number of deaths at a minimum of 156 and certainly indicate that many deaths are being classified as anything but AES.


By my very incomplete count, 1 death from Chhattisgarh, 5 from Manipur, 18 total fatal cases have been reported in Kerala to November 16 in addition to 17 fatal cases due to Nipah, 7 from Madhya Pradesh, 2 from Maharashtra, 2 from Gujarat, 1 from Punjab, 5 from Uttarakhand, 6 from Tamil Nadu and 1 fatal case from Tripura.


Thus the national toll is at a very minimum 506.

By comparison the Health Management Information System (to October) is reporting 10,591 tests conducted for JE of which 1,216 have returned positive. Of those, 5,684 and 484 respectively were from Uttar Pradesh. The same report tallies 307 AES deaths & 140 JE deaths nationwide of which 16 AES and 83 JE come from UP. - Ro

https://nrhm-mis.nic.in/hmisreports/frmstandard_reports.aspx

[Ronan Kelly]

Acute Encephalitis Syndrome		102	Female			Alive	November 10, 2018 Time : 11:40 am	City : BIJNOR Distt. : BIJNOUR State : UTTAR PRADESH
Acute Encephalitis Syndrome		96	Male			Alive	November 10, 2018 Time : 11:39 am	City : BIJNOR Distt. : BIJNOUR State : UTTAR PRADESH
Acute Encephalitis Syndrome		36	Female			Alive	October 27, 2018 Time : 11:58 am	City : BIJNOR Distt. : BIJNOUR State : UTTAR PRADESH

ages are in months.

http://idsurv.org/display-data.php

[Ronan Kelly]

Interesting report from Gorakhpur, Uttar Pradesh;

MOTHER,
THEY ARE NOT COUNTING
THE SMALLEST COFFINS
Gorakhpur remains on sick list as the body blows keep coming.
Despite the government's claims, children continue to die at Gorakhpur.
BY ANIRUDDHA GHOSAL
...
Sources at the ward maintained that from January till October 1, there have been a total of 218 deaths due to AES and JE, while 766 patients were admitted. Gorakhpur and Deoria accounted for more than half of the cases, while Gorakhpur has seen, at least, 36 deaths. A doctor, who didn?t wish to be named, said, ?What is most worrying is that the mortality rate is very high at over 28 per cent. Last year, where there were a lot more deaths, this hovered at around 21 per cent.?

The reason, a doctor claimed, was partly diagnosis. ?This year, a lot of patients are being entered into the government?s records as suffering from Acute Febrile Illness (AFI), which, simply put, is high fever. So even if the patient dies of what is later found to be AES, the records don?t show that they had AES. This is a factor in the skewed numbers.?
...
The numbers at the BRD Medical College are grim. As of September 1, the combined death toll of the neonatal intensive care unit (NICU) and the paediatric intensive care unit (PICU) was 1,637, with deaths at NICU accounting for 1,006 of these, said sources. Last year, for the same time period, this was at 1,812, with deaths at the NICU accounting for 1,101, said sources. In other words, the situation has improved from roughly 22 children dying every three days to 20 children dying every three days.
...
The numbers at the BRD Medical College are grim. As of September 1, the combined death toll of the neonatal intensive care unit (NICU) and the paediatric intensive care unit (PICU) was 1,637, with deaths at NICU accounting for 1,006 of these, said sources. Last year, for the same time period, this was at 1,812, with deaths at the NICU accounting for 1,101, said sources. In other words, the situation has improved from roughly 22 children dying every three days to 20 children dying every three days.
...
At the AES ward and the rest of Gorakhpur, posters and banners reiterate the government?s claims of vaccinating every single child for JE under its Dastak campaign. But sources in the paediatric and pathology departments pointed to a worrying trend: there have been 110 cases of JE till September, of which 23 were from Bihar. During the same period in 2017 this was at 83. Though the hospital officially denied this, sources said this indicated an increase of 24 per cent in the caseload.
...

https://www.news18.com/news/immersive/gorakhpur-child-deaths.html

[Ronan Kelly]

22 NOVEMBER 2018 Last Updated at 7:56 PM | SOURCE: PTI
Samajwadi Party MP demands 500-bed encephalitis ward be opened in Gorakhpur


Gorakhpur (UP), Nov 22 Samajwadi Party MP Praveen Nishad demanded on Thursday that a 500-bed encephalitis ward be opened in the district as he submitted a memorandum asking the administration to ensure transparency in data of deaths due to the disease.

SP members led by MP Nishad and party district president Prahlad Yadav marched from the BRD Medical College here to Commissioner's office and handed over a two-point memorandum addressed to the Governor.

The MP said 98 per cent construction work of the 500-bed ward was completed during the previous Akhilesh Yadav regime but instead of opening it, the present government is focusing on construction of other encephalitis ward.
...

https://www.outlookindia.com/newsscroll/samajwadi-party-mp-demands-500bed-encephalitis-ward-be-opened-in-gorakhpur/1426294

[Ronan Kelly]

From week 38 outbreak report: https://idsp.nic.in/WriteReadData/l892s/382018.pdf

MN/UKH/2018/38/1272 Manipur Ukhrul Japanese
Encephalitis 18 00 22-09-18 23-09-18 Under
Control
Cases reported from several areas of Lamlai
Makha Leikai Imphal East District, Kaidem
Leikai Khurai, Imphal East District, Near
Limaram Water Fall, Bishnupur and Lumphou
Kangpokpi Senapati District. District RRT
investigated the outbreak. House to house
survey done. Out of 18 blood samples collected
and sent to State Referral lab JNIMS; 1 sample
were positive for JE IgM ELISA. All cases
treated symptomatically. Source reduction
activities undertaken. Health education given.

Week 39: https://idsp.nic.in/WriteReadData/l892s/392018.pdf

AS/CCR/2018/39/1295 Assam Cachar Japanese
Encephalitis 05 00 06-07-18 Under
Control
Cases reported from Village/SC Madhurbond, BPHC
Lakhipur. District RRT investigated the outbreak. House to
house survey done. All the 5 serum samples collected and
tested at SMCH, Cachar were positive for JE (IgM ELISA).
Fogging and source reduction activities undertaken in the
affected areas. All cases treated symptomatically. Health
education given.

AS/GLP/2018/39/1298 Assam Goalpara
Japanese
Encephalitis 35 cases 01 fatality 09-08-18
Under Surveillance
Cases reported from several villages Pakhriguri, Makripori,
Fofonga, Paharsingpara, Nayapara, Harimura, Dhaigaon,
Rakshyasini, SC Godharbori, Rakshyasini, Dhaigaon, PHC
Krishnai, Badahapur, Harimura, Block Mornai. District
RRT investigated the outbreak. House to house survey done.
Out of 35 serum samples collected and tested at GMCH,
Guwahati and DPHL, Goalpara 18 samples were positive
for JE (IgM ELISA). Death occurred in a 25 year old male.
Fogging and source reduction activities undertaken in the
affected areas. All cases treated symptomatically. Health
education given.

[Ronan Kelly]

Week 40 IDSP report: https://idsp.nic.in/WriteReadData/l892s/402018.pdf

CT/SBT/2018/40/1327 Chhattisgarh Dantewada Japanese
Encephalitis 01 case 01 fatality 30-09-18 04-10-18 Under
Surveillance
Case reported from Village Tilpara, SC
Ganjenar, PHC Bacheli, Block Dantewada.
District RRT investigated the outbreak. House
to house survey done. Death occurred in 4yr old
male child. Serum sample collected and sent to
Baliram Kashyap Memorial Medical College,
Jagdalpur was psotive for Je (IgM ELISA).
Awareness regarding use of mosquito nets was
done. Health education given.

Week 41 IDSP Report: https://idsp.nic.in/WriteReadData/l892s/412018.pdf

JH/GDA/2018/41/1352 Jharkhand Godda Japanese
Encephalitis 09 00 09-10-18 10-10-18 Under
Surveillance
Cases reported from Villages Boarijore,
Lohandia, Dakaita, Lalmatia. District RRT
investigated the outbreak. House to house
survey done. 5 blood samples collected and sent
to RIMS, Ranchi were positive for JE (IgM
ELISA). All cases treated symptomatically.
Fogging and source reduction activities
undertaken in the affected areas. Health
education given regarding use of mosquito bed
nets and personal protection measures.

[Ronan Kelly]

Woman dies of Japanese Encephalitis in AMCH, Dibrugarh
December 7, 2018
A Correspondent

Joysagar: Ranju Konwar (47) of Betonibam gaon under Netaipukhuri Police Station area of Sivasagar district died on Wednesday night. Sources informed that the woman was suffering from Japanese Encephalitis and was undergoing treatment in AMCH, Dibrugarh since some days.
...

https://www.sentinelassam.com/news/woman-dies-of-japanese-encephalitis-in-amch-dibrugarh/

[Ronan Kelly]

...

http://nvbdcp.gov.in/WriteReadData/l892s/20924647841544509054.pdf

Comment: I remain skeptical of the numbers coming out of Uttar Pradesh. Up to June 29th 112 fatalities from 1,171 cases (9.6%) were reported, 11 fatalities from 1,517 cases (0.73%) were tallied from July to October, then 23 deaths from 186 cases (12.3%) in the past month. Media reports put the total number of deaths at a minimum of 156 and certainly indicate that many deaths are being classified as anything but AES.


By my very incomplete count, 1 death from Chhattisgarh, 5 from Manipur, 18 total fatal cases have been reported in Kerala to November 16 in addition to 17 fatal cases due to Nipah, 7 from Madhya Pradesh, 2 from Maharashtra, 2 from Gujarat, 1 from Punjab, 5 from Uttarakhand, 6 from Tamil Nadu and 1 fatal case from Tripura.


Thus the national toll is at a very minimum 508.

By comparison the Health Management Information System (to November) is reporting 18,474 tests conducted nationwide for JE of which 1,896 have returned positive. Of those, 12,802 and 1,056 respectively were from Uttar Pradesh. The same report tallies 356 AES deaths & 153 JE deaths nationwide of which 17 AES and 89 JE come from UP. - Ro

https://nrhm-mis.nic.in/hmisreports/frmstandard_reports.aspx

[Ronan Kelly]

Odisha

Massive intervention helps curb Japanese Encephalitis in Malkangiri
A massive vaccination drive along with a series of interventions and awareness programmes have ensured zero deaths due to JE virus.


Published: 12th December 2018 09:36 AM | Last Updated: 12th December 2018 09:36 AM | A+A A-

MALKANGIRI: With massive intervention on multiple fronts, the district administration has finally been able to control Japanese Encephalitis (JE).The mosquito-borne disease caused by JE virus had claimed at least 34 lives in the Koya tribe dominated villages in 2016. Two years hence, with an all-out war declared against the disease by the district administration, its recurrence has been prevented. Of the 103 deaths reported in 2016, about 34 were due to Japanese Encephalitis (JE) while the remaining were caused by Acute Encephalitis Syndrome (AES). No deaths due to JE have been reported in the last two years.

Massive vaccination drive, multiple strategies, series of interventions and awareness programmes undertaken by the administration with the active participation of all ASHA, AWW, health workers and PRI members in the last two years has helped in controlling JE trend in the district, Malkangiri Collector Manish Agarwal said.
...

http://www.newindianexpress.com/states/odisha/2018/dec/12/massive-intervention-helps-curb-je-1910457.html

[Ronan Kelly]

Comment - Interestingly, these cases have not been reported by the NVBDCP, see post 144 above. - Ro


...

https://timesofindia.indiatimes.com/city/pune/with-108-patients-je-spreads-beyond-the-endemic-zone/articleshow/67099190.cms

[Ronan Kelly]

Week 42 IDSP report: https://idsp.nic.in/WriteReadData/l892s/422018.pdf

CT/SBT/2018/42/1372 Chhattisgarh Dantewada Japanese
Encephalitis 04 cases 01 fatality 15-10-18 20-10-18 Under
Surveillance
Cases reported from Village Kankipara, SC
Marenda, PHC Marenda, Block Kuwakonda.
District RRT investigated the outbreak. House
to house survey done. Domestic pigs were
found in the households. Death occurred in 3yr
old male child. Out of 4 serum sample collected
and sent to Baliram Kashyap Memorial Medical
College, Jagdalpur 3 samples were positive for
JE (IgM ELISA). Community was advised to
keep all the pigs on the far flung places and use
the LLIN Mosquito Nets. Source reduction
activities undertaken. Health education given

UA/UDH/2018/42/1382 Uttarakhand Udham Singh
Nagar
Japanese
Encephalitis 15 00 21-08-18 21-10-18 Under
Con [sic - the report is incomplete - Ro]

Comment - The NVBDCP does not include a line for Chhattisgarh, but the Health Management Information System (to November) is reporting 50 JE tests & 6 positives with no deaths from AES or JE.

[Ronan Kelly]

Congress walks out of Uttar Pradesh Assembly over Gorakhpur encephalitis deaths
Congress Legislature Party leader Ajay Kumar had sought to know the number of deaths due to Japanese Encephalitis and Acute Encephalitis Syndrome.


Published: 21st December 2018 02:44 PM | Last Updated: 21st December 2018 02:44 PM | A+A A-

LUCKNOW: The Congress walked out of the Uttar Pradesh Assembly on Friday, alleging that the state government had imposed an "emergency" in BRD Medical College to hide actual figures of encephalitis deaths in Gorakhpur from the media.

The matter was raised during the Question Hour by Congress Legislature Party (CLP) leader Ajay Kumar Lallu. He sought to know the number of deaths due to Japanese Encephalitis (JE) and Acute Encephalitis Syndrome (AES).

Responding to him, Health Minister Siddharth Nath Singh claimed that compared to previous years, encephalitis cases and deaths have come down due to the government's sustained efforts.

"Due to training and awareness, the encephalitis cases and deaths have come down. In the budget, for the first time Rs 20 crore was earmarked for the awareness drive and people from all walks (of life) were associated with the campaign due to which we got success in containing the disease," he said.

Lallu, however, claimed that in Gorakhpur alone scores of people had died due to encephalitis.
...

http://www.newindianexpress.com/nation/2018/dec/21/congress-walks-out-of-uttar-pradesh-assembly-over-gorakhpur-encephalitis-deaths-1914639.html

[Ronan Kelly]

...

http://nvbdcp.gov.in/WriteReadData/l892s/25510462041546326501.pdf

Comment: I remain skeptical of the numbers coming out of Uttar Pradesh. Up to June 29th 112 fatalities from 1,171 cases (9.6%) were reported, 11 fatalities from 1,517 cases (0.73%) were tallied from July to October, then 107 deaths from 392 cases (27.3%) in the past two months. The overall cfr for the year is 7.5%. Media reports indicate that many deaths are being classified as anything but AES.


By my very incomplete count, 2 deaths from Chhattisgarh, 5 from Manipur, 18 total fatal cases have been reported in Kerala to Dec 31 in addition to 17 fatal cases due to Nipah, 7 from Madhya Pradesh, 2 from Maharashtra, 2 from Gujarat, 1 from Punjab, 5 from Uttarakhand, 6 from Tamil Nadu and 1 fatal case from Tripura.


Thus the national toll is at a very minimum 658.

By comparison the Health Management Information System (to December) is reporting 19,179 tests conducted nationwide for JE of which 1,866 (lower than the November figure - sigh) have returned positive. Of those, 12,802 and 1,056 respectively were from Uttar Pradesh (which is the same as the November figures). The same report tallies 402 AES deaths & 153 JE deaths nationwide of which 17 AES and 89 JE come from UP (same as November). - Ro

https://nrhm-mis.nic.in/hmisreports/...d_reports.aspx

[Ronan Kelly]

From Week 49 IDSP report: https://idsp.nic.in/WriteReadData/l892s/492018.pdf

MG/JTH/2018/49/1560 Meghalaya Jaintia Hills
Japanese
Encephalitis 42 cases 06 fatalities 02-08-18 Under
Surveillance
Cases reported from Village Thadlaskein Block Laskein
Block. District RRT investigated the outbreak. House to
house survey done. Males affected more than females More
number of cases seen in age group 0-15 years Most of the
cases were unvaccinated or with unknown vaccination
status. IEC done. Field investigation and Entomological
Study done from 30-10-18 to 21-11-8 at Nartiang
(Umladang village) and Namdong (Ringkyrtein, Tamu,
Krem Myrsiang village). 42 Samples (Serum CSF) Positive
so far based on test reports received from Civil Hospital
Shillong and NEIGRIHMS, Shillong. All cases treated
symptomatically. Health education given